Letter by CCCB President to Prime Minister Stephen Harper, urging the federal government to focus on the needs for palliative care in Canada

End-of-life issues will be among the questions at the forefront of Canadian politics and debates over the coming months. Once again, the Canadian Conference of Catholic Bishops urges political and social leaders to insist on clear and mutually understood definitions of the terms being used, so the discussions can be focused and helpful.

At the same time, despite the media coverage which will no doubt continue to centre on euthanasia and assisted suicide, we encourage you to focus on the positive steps that can be taken to secure truly compassionate palliative care options for all Canadians.

The most recent round of deliberations on end-of-life choices was sparked in May 2009 by MP Francine Lalonde’s tabling of Private Members Bill C-384, An Act to Amend the Criminal Code, Right to Die with Dignity. Over the past months, this controversial topic has been further fueled by international and domestic discussions, including the Commission spéciale sur la question de mourir dans la dignité of the Quebec National Assembly which began its investigation into euthanasia and assisted suicide this February and March, in order to prepare for a public consultation this fall.

In the midst of this increasingly intense debate, we invite you to turn your attention to the more pressing matter of palliative care. Although the means are available to assure that everyone in our country can die with the assurance of receiving physical, psychological, social, spiritual and practical care as well as support, the majority of Canadians, particularly those in rural areas and many small urban communities, do not have access to appropriate care in their final months, weeks or days.

In her 2005 progress report on palliative care, Still Not There: Quality End-of-Life Care, The Honourable Sharon Carstairs, P.C., notes the need for federal leadership on this question, pointing out it is estimated that “no more than 15% of Canadians have access to hospice palliative care,” and that for “children, that figure falls to 3.3%” (pp. 1, 27). Commenting further in a talk on 3 March 2006 at the University of St Michael’s College, Toronto, she has stated that “until every single Canadian can be guaranteed quality end-of-life care so that they have a legitimate choice to make … we cannot start the [euthanasia] debate. We are not there yet, and we are a long way from being there yet.”

Should Parliament decide to legalize euthanasia and assisted suicide before ensuring that every Canadian has access to palliative care, our government will not be allowing individuals a truly free choice. Rather, many of our most vulnerable citizens will feel pressured to ask for euthanasia or assisted suicide as a last resort because our society fails to provide them with basic care.

In order to respond to these basic needs and concerns of our Canadian sisters and brothers, the Catholic Bishops of Canada have been encouraging national, provincial and community efforts to promote palliative care, including hospices, home care and pharmacare.

For this reason, the Canadian Conference of Catholic Bishops endorses the palliative care initiative that was proposed in October 2009 by Dr José Pereira, chief of palliative medicine at Bruyère Continuing Care in Ottawa. Together with Dr Pereira, we urge the Government of Canada to set aside $20 million for the development of a palliative care system. We are convinced that the adoption of a national strategy on palliative and end-of-life care would benefit our entire country, by responding compassionately to the full range of needs that persons experience as they face the end of life, and at the same time respecting their inherent dignity and value. It is our firm belief that every person is entitled to the benefits of palliative care, which provide patients and their families with the opportunity to experience the unique challenges and unexpected joys of the final stages of life.

The Canadian Conference of Catholic Bishops is confident that our country is capable of providing its citizens with end-of-life care which respects their lives and acknowledges the inviolability of each human life. We look forward to the day when all Canadians will receive the care they deserve as they prepare for their final journey. We also believe that the federal government has an important leadership role in assuring that this care is provided.

Thank you for considering our requests. We look forward to hearing how your government will insist on a common understanding of the basic terminology involved with questions of euthanasia and assisted suicide, and how you will also support the development of a palliative care system for our country.

Sincerely,

+ Pierre Morissette

Most Reverend Pierre Morissette Bishop of Saint-Jérôme President Canadian Conference of Catholic Bishops